The legislation establishes the obligation for foreigners in the Czech Republic to be insured if they are not participants of the Czech public health insurance (e.g. foreigners with permanent residence, foreigners/employees). Previous legislation excluded minor children of foreigners under the age of 18 from access to public health insurance. Children of foreigners, unlike Czech children, were legally obliged to take out private commercial health insurance.

What changes will take place from January 2024?

All foreigners under the age of 18 will now be covered by public health insurance. This measure applies to the children of foreigners who have been granted long-term residence in the Czech Republic, regardless of the purpose of their stay (it does not apply to children with a long-term visa or with a temporary residence permit for family members of an EU citizen).

Unlike Czech children, where the insurance is paid by the state, the insurance of children of foreigners with long-term residence is paid by the legal representative, curator or guardian of the minor. Participation in the public health insurance is compulsory by law and the premium is paid for the entire reference period. A child born in the territory of the Czech Republic from 1 January 2024 to a mother with a long-term residence permit becomes a participant in the public health insurance for the entire period of the long-term residence permit application procedure. However, the legal representative must submit the application for long-term residence within 60 days of the date of birth and fulfil his/her reporting obligation to the health insurance company within 8 calendar days of the birth. The insurance premiums are subsequently paid by the legal representative, guardian or curator.

How should foreigners who already reside in the territory, extend their stay for their children or have private comprehensive health insurance be treated?

• If, as of 1 January 2024, a foreigner under the age of 18 is staying in the territory on the basis of the so-called fiction of residence (his/her application for extension of long-term residence has not yet been processed) and his/her private health insurance has been arranged only until the end of 2023, the legal representative must register him/her for public health insurance within 8 calendar days (i.e. from 1 January 2024 to 8 January 2024). If the legal representative of a foreigner under the age of 18 fails to do so, the foreigner will start to incur an insurance debt.
• If the foreigner has a private health insurance contract as of 1 January 2024 that will expire in the future (e.g. during 2024), he/she must register for public health insurance at least 8 calendar days before the expiry date. Thus, the minor child will become a participant in public health insurance on the day after the expiry of the private comprehensive health insurance.

We emphasise that the transition from private to public health insurance must be smooth and there must not be a period when children of foreigners are not insured.

If one of the parents is a permanent resident and applies for permanent residence for a child born in the Czech Republic within 60 days, the child is a participant in public health insurance until the end of the calendar month in which the child reaches 60 days of age, and then remains a participant in public health insurance as a permanent residence holder. The legal representative, guardian or curator must also fulfil the obligation to report to the public health insurance company within 8 calendar days of the child’s birth.

Another important change is the end of the monopoly with the VZP Insurance Company (“PVZP”), which is a subsidiary of VZP, in arranging comprehensive health insurance, which was previously provided for by law. The amendment to the Act on the Residence of Foreign Nationals, which abolishes the said monopoly, has already gone through the entire legislative process and the Act came into force on 20 September 2023. It will now be possible to arrange comprehensive health insurance with any insurance company authorised to provide such insurance. At the same time, the amount of the insurance benefit changes, with the limit now being increased from €60,000 to €400,000.

The options for terminating the insurance contract with the PVZP and other conditions for negotiating the new comprehensive insurance will be published in the coming weeks. We will summarise them in a separate article.

The Czech Republic will join other European countries

The change in access to health insurance for children of foreigners has brought the Czech Republic closer to other European countries. Their inclusion in public health insurance will allow better access to healthcare for foreigners under the age of 18.